Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.46 / $12.46 / $12.46	Facility	26	$12.46	$12.46	$12.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.18 / $108.70 / $164.40	Professional		$74.18	$108.70	$164.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $12.73 / $43.64	Professional	26	$10.85	$12.73	$43.64
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.09 / $45.86 / $68.48	Professional	52	$37.09	$45.86	$68.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.08 / $90.41 / $130.94	Professional	TC	$67.08	$90.41	$130.94
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.21 / $9.21 / $9.21	Facility	26	$9.21	$9.21	$9.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.12 / $218.56 / $289.76	Professional		$127.12	$218.56	$289.76
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $30.97 / $41.06	Professional	26	$18.16	$30.97	$41.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $124.05 / $201.30 / $253.82	Professional	TC	$124.05	$201.30	$253.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.25 / $39.42 / $94.82	Facility	26	$25.25	$39.42	$94.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.70 / $228.21 / $355.37	Professional		$113.70	$228.21	$355.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.11 / $30.49 / $47.48	Professional	26	$14.11	$30.49	$47.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $101.75 / $197.72 / $307.89	Professional	TC	$101.75	$197.72	$307.89
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $21.89 / $34.75 / $74.66	Facility	26	$21.89	$34.75	$74.66
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $139.90 / $223.61 / $321.10	Professional		$139.90	$223.61	$321.10
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $18.69 / $29.67 / $42.90	Professional	26	$18.69	$29.67	$42.90
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $121.21 / $193.97 / $278.20	Professional	TC	$121.21	$193.97	$278.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.86 / $125.86 / $125.86	Facility	26	$125.86	$125.86	$125.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.65 / $179.26 / $768.54	Professional		$97.65	$179.26	$768.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $25.47 / $267.48	Professional	26	$13.49	$25.47	$267.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.14 / $154.00 / $698.48	Professional	TC	$85.14	$154.00	$698.48
United Facility/Professional Professional Modifier Low / Median / High Price $95.28 / $171.78 / $316.95	Professional		$95.28	$171.78	$316.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $24.52 / $45.85	Professional	26	$12.99	$24.52	$45.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.98 / $140.75 / $259.91	Professional	TC	$80.98	$140.75	$259.91